MEDICARE: LINDSEY ANNE DORITY LAC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	150296	OR

General Provider Information

NPI Number	:	1710209614
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSEY ANNE DORITY LAC

Provider Business Mailing Address
First Line	:	200 NE 20TH AVE
Second Line	:	SUITE 160
City	:	PORTLAND
State	:	OR
Zip	:	97232-3094
Country	:	US
Telephone Number	:	503-484-5402
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 NE 20TH AVE
Second Line	:	SUITE 160
City	:	PORTLAND
State	:	OR
Zip	:	97232-3094
Country	:	US
Telephone Number	:	503-484-5402
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/18/2010
Last Update Date	:	02/08/2016

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Directions to “ LINDSEY ANNE DORITY LAC” Practice Location

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